Hydrocotyle asiatica

Gotu kola/Drug Interactions:

  • Alzheimer's agentsAlzheimer's agents: Ayurveda regards gotu kola as an important rejuvenating herb for nerve and brain cells, capable of increasing intelligence, longevity, and memory. Asiaticoside derivatives, including asiatic acid and asiaticoside 6, were shown to reduce hydrogen peroxide-induced cell death, decrease free radical concentrations, and inhibit beta amyloid cell death in vitro, suggesting a possible role for gotu kola in the treatment and prevention of Alzheimer's disease and beta amyloid toxicity (3). One clinical trial investigated a combination product containing gotu kola on cognitive function in the elderly, but did not find any benefit (48).
  • Anti inflammatory agentsAnti inflammatory agents: Gotu kola may theoretically have synergistic effects when taken concomitantly with anti-inflammatory agents. In rats, Madecassol? was shown to decrease the severity of radiation-induced dermatitis vs. control (34).
  • Antianxiety drugsAntianxiety drugs: Research suggests that gotu kola has anxiolytic properties (31; 32; 33). Therefore, gotu kola may have synergistic effects when taken in combination with anxiolytics.
  • AntibioticsAntibiotics: Gotu kola may have some additive effects when taken with antibiotics. An in vitro study of Centella asiatica powder found no activity against the acid-fastness or viability of M. tuberculosis, despite its use in the treatment of leprosy (M. leprae) (64). A subsequent in vitro study found asiaticoside to have little microbicidal activity against M. tuberculosis or M. leprae; however, when incorporated into liposomal form, the microbicidal activity of asiaticoside was greatly increased (65).
  • Antidiabetic agentsAntidiabetic agents: Gotu kola has been found in large doses to elevate blood glucose levels in an animal study (29), and may counteract the effects of drugs that reduce serum glucose levels. Careful monitoring and dose adjustments may be necessary.
  • Antilipemic agentsAntilipemic agents: Based on findings of an animal study (29), gotu kola in large doses may possess lipid-lowering properties that potentiate the effects of other anti-hyperlipidemic agents.
  • Antineoplastic agentsAntineoplastic agents: In vitro, partially purified fractions of Centella asiatica crude extract significantly inhibited proliferation of cancerous cells in a dose-dependent fashion, with no toxic effects to human lymphocytes (11). In mice, oral administration of both crude extract of Centella asiatica and partially purified fractions of the crude extract slowed the development of solid and ascites tumors, and increased the lifespan of mice, with possible action directly on DNA synthesis (11).
  • Antiviral agentsAntiviral agents: Centella asiatica extract and asiaticoside are active against herpes simplex virus in vitro (66; 67).
  • CNS depressantsCNS depressants: Based on findings of an animal study (29), gotu kola may possess sedative qualities that potentiate the effects of other sedative agents.
  • CorticosteroidsCorticosteroids: In a 1976 animal study of wound healing, observed benefits of intramuscular asiaticoside (from gotu kola) were antagonized by subcutaneous administration of dexamethasone (30). However, steroids are known to interfere with healing due to immunosuppressant properties, and the observed effects in this study may not be specific to asiaticoside. In addition, asiaticoside has not been demonstrated to improve wound healing in humans, and the safety of intramuscular asiaticoside is not clear.
  • Cytochrome P450 2C9 inhibitorsCytochrome P450 2C9 inhibitors: Based on secondary sources, gotu kola may interact with cytochrome P450 2C9 inhibitors.
  • Cytochrome P450 2D6 inhibitorsCytochrome P450 2D6 inhibitors: Based on secondary sources, gotu kola may interact with cytochrome P450 2D6 inhibitors.
  • Cytochrome P450 3A(4,5,7) inhibitorsCytochrome P450 3A(4,5,7) inhibitors: Based on secondary sources, gotu kola may interact with cytochrome P450 2D6 inhibitors.
  • Cytochrome P450 metabolized agentsCytochrome P450 metabolized agents: Based on secondary sources, gotu kola may interact with drugs that are metabolized by the cytochrome P450 system.
  • DiureticsDiuretics: Gotu kola may have synergistic effects when taken concomitantly with diuretics.
  • Fertility agentsFertility agents: Animal study shows a consistent reduction of fertility in female mice after the ingestion of isothankuniside and its derivative BK compound, both of which are isolated from Centella asiatica (5).
  • Hepatotoxic agentsHepatotoxic agents: Gotu kola may cause hepatotoxicity and theoretically may increase the potential for liver damage when used with other hepatotoxic agents (35)..
  • Hormonal agentsHormonal agents: Gotu kola may have synergistic effects when taken concomitantly with hormonal agents.
  • PhenylbutazonePhenylbutazone: In a 1976 animal study of wound healing, observed benefits of intramuscular asiaticoside (from gotu kola) were antagonized by subcutaneous administration of phenylbutazone (30). The application to humans is not clear, and intramuscular asiaticoside has not been demonstrated to be safe or efficacious for wound healing in humans.
  • SedativesSedatives: Based on findings of an animal study (29), gotu kola may possess sedative qualities that potentiate the effects of other sedative agents.
  • VasodilatorsVasodilators: Gotu kola may have additive effects when taken concomitantly with vasodilators.

    • Gotu kola/Herb/Supplement Interactions:

  • Alzheimer's herbsAlzheimer's herbs: Ayurveda regards gotu kola as an important rejuvenating herb for nerve and brain cells, capable of increasing intelligence, longevity, and memory. Asiaticoside derivatives, including asiatic acid and asiaticoside 6, were shown to reduce hydrogen peroxide-induced cell death, decrease free radical concentrations, and inhibit beta amyloid cell death in vitro, suggesting a possible role for gotu kola in the treatment and prevention of Alzheimer's disease and beta amyloid toxicity (3). One clinical trial investigated a combination product containing gotu kola on cognitive function in the elderly, but did not find any benefit (48).
  • Anti inflammatory herbsAnti inflammatory herbs: Gotu kola may theoretically have synergistic effects when taken concomitantly with anti-inflammatory herbs. In rats, Madecassol? was shown to decrease the severity of radiation-induced dermatitis vs. control (34).
  • AntibacterialsAntibacterials: Gotu kola may have some additive effects when taken with antibacterial herbs. An in vitro study of Centella asiatica powder found no activity against the acid-fastness or viability of M. tuberculosis, despite its use in the treatment of leprosy (M. leprae) (64). A subsequent in vitro study found asiaticoside to have little microbicidal activity against M. tuberculosis or M. leprae; however, when incorporated into liposomal form, the microbicidal activity of asiaticoside was greatly increased (65).
  • AntilipemicsAntilipemics: Based on findings of an animal study (29), gotu kola in large doses may possess lipid-lowering properties that potentiate the effects of other anti-hyperlipidemic agents such as garlic (Allium sativum L.).
  • AntineoplasticsAntineoplastics: In vitro, partially purified fractions of Centella asiatica crude extract significantly inhibit proliferation of cancerous cells in a dose-dependent fashion, with no toxic effects to human lymphocytes (11). In mice, oral administration of both crude extract of Centella asiatica and partially purified fractions of the crude extract slow the development of solid and ascites tumors, and increase the lifespan of mice, with possible action directly on DNA synthesis (11).
  • AntioxidantsAntioxidants: Asiaticoside derivatives, including asiatic acid and asiaticoside 6, were shown to reduce hydrogen peroxide-induced cell death, decrease free radical concentrations, and inhibit beta amyloid cell death in vitro, suggesting a possible role for gotu kola in the treatment and prevention of Alzheimer's disease and beta amyloid toxicity (3).
  • AntiviralsAntivirals: Centella asiatica extract and asiaticoside are active against herpes simplex virus in vitro (66; 67).
  • AnxiolyticsAnxiolytics: Research suggests that gotu kola has anxiolytic properties (31; 32; 33).. Therefore, gotu kola may have synergistic effects when taken in combination with anxiolytics, such as bacopa, kava, lavender, lemon balm, peppermint, St. John's wort, or valerian.
  • ContraceptivesContraceptives: Animal study shows a consistent reduction of fertility in female mice after the ingestion of isothankuniside and its derivative BK compound, both of which are isolated from Centella asiatica (5)
  • Cytochrome P450 2C9 inhibitorsCytochrome P450 2C9 inhibitors: Based on secondary sources, gotu kola may interact with cytochrome P450 2C9 inhibitors.
  • Cytochrome P450 2D6 inhibitorsCytochrome P450 2D6 inhibitors: Based on secondary sources, gotu kola may interact with cytochrome P450 2D6 inhibitors.
  • Cytochrome P450 3A(4,5,7) inhibitorsCytochrome P450 3A(4,5,7) inhibitors: Based on secondary sources, gotu kola may interact with cytochrome P450 3A(4,5,7) inhibitors.
  • Cytochrome P450 metabolized herbs and supplementsCytochrome P450 metabolized herbs and supplements: Based on secondary sources, gotu kola may interact with herbs and supplements that are metabolized by the cytochrome P450 system.
  • DiureticsDiuretics: Gotu kola may have synergistic effects when taken concomitantly with diuretics, such as aloe, astragalus, green tea, or ginkgo.
  • Ginkgo bilobaGinkgo biloba: One study used a combination supplement that included 160mg Ginkgo biloba, 68mg gotu kola, and 180mg decosahexaenoic acid (48).
  • Hepatotoxic herbs and supplementsHepatotoxic herbs and supplements: Gotu kola may cause hepatotoxicity and theoretically may increase the potential for liver damage when used with other hepatotoxic agents (35)..
  • Hormonal herbs and supplementsHormonal herbs and supplements: Gotu kola may have synergistic effects when taken concomitantly with hormonal herbs and supplements, such as black cohosh, chamomile, soy, or St. John's wort.
  • HypoglycemicsHypoglycemics: Gotu kola has been found in large doses to elevate blood glucose levels in an animal study (29), and may counteract the effects of agents that reduce serum glucose levels, or add to the effects of hyperglycemic agents. Careful monitoring and dose adjustments may be necessary.
  • ImmunostimulantsImmunostimulants: Gotu kola may have additive effects when taken concomitantly with immunostimulants, such as astragalus, ginger, goldenseal, or propolis.
  • Omega-3 fatty acids, fish oil, alpha-linolenic acidOmega-3 fatty acids, fish oil, alpha-linolenic acid: One study used a combination supplement that included 160mg Ginkgo biloba, 68mg gotu kola, and 180mg decosahexaenoic acid (48).
  • SedativesSedatives: Based on findings of an animal study (29), gotu kola may possess sedative qualities that potentiate the effects of other sedative agents.
  • Vasodilator herbs and supplementsVasodilator herbs and supplements: Gotu kola may have additive effects when taken concomitantly with vasodilator herbs and supplements, such as aconite, black cohosh, fenugreek, or garlic.

    • Gotu kola/Food Interactions:

  • GeneralGeneral: A case report exists of night eating syndrome associated with gotu kola (68)

    • Gotu kola/Lab Interactions:

  • Blood glucose levelsBlood glucose levels: In an animal study, large doses of gotu kola have been found to elevate blood glucose levels (29).
  • Liver panelLiver panel: Elevated liver enzymes have been reported with gotu kola use (35).
  • Serum cholesterol levelsSerum cholesterol levels: In an animal study, large doses of gotu kola have been found to increase blood cholesterol levels (29).